Neurolgical Emergencies Treatment Trials ( NETT ) research network was established to develop new therapies for acute neurological illness and injury. By bringing together likeminded and dedicated researchers at several academic institutions across the US, the NETT provides an efficient and effective means to rapidly study and advance the science needed for medical progress. This proposal is for renewal ofthe University of Minnesota NETT Hub . We currently have 9 Spokes , with recent additions increasing our catchment area to cover most population centers in our State. We engage at least 30 clinician investigators at these sites. We partner with state patient advocacy groups and include education and clinical outreach as well as research in our mission. As the coordinating center for several urban and rural, academic and community Spokes, the Minnesota Hub has promoted and provided successful Spoke development, and the recruitment and enrollment of patients into all NETT studies implemented so far, and looks forward to partipcation in future NETT clinical trials. The Minnesota Hub has used the lessons learned from one study to streamline the start up ofthe next. This includes , among others, the development of different models for Hub support of Spokes, a one number alert system to deploy an on- call Hub research team, an IRB approved prototype for rapid evaluation and implementation of Exception from Informed Consent ( EFIC) studies, exploration of telemedicine for enrollment and consent of patients at remote sites, creative budgeting to ensure adequate reimbursment for certification and training time for Spoke investigators, and a secure storage cabinent and tracking system for study drugs used out of hospital. The specific aims of this proposal are ; 1) to use lessons learned to efficiently implement additonal ( 4-7 ) trials performed by the NETT 2) to actively develop exisitng and new spokes and investigators in their independent research capacities 3) to serve as a state wide resource for patients and the neuroscience and emergency medical communities